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By Luis H. Toledo-Pereyra (Other Contributor)

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B. Saunders Company 1990. Suspicious lesions are sampled. Arteriovenous malformations, located below the visceral pleura, are ligated or excised as appropriate. Landreneau and colleagues reported 100% success in VATS drainage and pleural debridement of spontaneous hemothorax in their 23 patients. 24 No complications occurred but there was 1 death unrelated to the hemothorax. 9 days. Patient selection impacts conversion rates. Those patients with a firm, fibrous peel will likely require conversion to thoracotomy for successful operative intervention.

Long-term follow-up is required to define the durability of the operation. Whether LVRS extends survival in patients with severe emphysema is unknown. Perhaps more importantly, a careful analysis of the impact of LVRS on exercise capacity and quality of life will more appropriately define the utility of this intervention. 19 Thorascopic Lung Biopsy for Interstitial Lung Disease Interstitial lung disease (ILD) represents a heterogeneous group of lung conditions of both known or unknown etiologies.

Open thoracotomy is the best option when initial blood drainage by thoracostomy exceeds 1000 cc, there is ongoing drainage of 200 cc/hr or more in 8 hours or >100 cc/hr for 24 hours. If closed tube thoracostomy does not drain the clotted blood within 5-7 days, VATS should be considered for its full evacuation before a dense fibrous peel develops. Open thoracotomy and decortication is required once a dense peel develops. The treatment goal is to provide symptomatic relief and to salvage lung function by removing loculated fluid collections and removing adhesions that prevent full lung expansion.

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